Inter Press Service - November 29, 2001
Emad Mekay

The Bank also is taking part in a 30-minute documentary scheduled to run Saturday - World AIDS Day - on the international popular- culture television network MTV.

The lender says it will consider an additional 500 million dollars in interest-free loans to developing countries with strong national HIV/AIDS strategies, especially those in Africa, home to an estimated 25 million of the world's 36 million HIV-positive people.

Debrework Zewdie, a medical scientist from Ethiopia, is to be the lending institution's first Global HIV/AIDS Adviser.

Global attention has been preoccupied with terrorism in the wake of the "huge tragedy" of Sep. 11, Zewdie told IPS, but "the world shouldn't move its eye from the danger of the AIDS epidemic, which could consume us all."

AIDS is estimated to have killed 22 million people since the first case was diagnosed two decades ago.

Some three billion dollars is needed every year to fund basic prevention, care and treatment programs across Africa alone, according to joint estimates by the Bank and UNAIDS, the U.N. joint AIDS programme.

The Bank, in a statement, says some 20 African countries already have applied for new financing from its soft loan window, the International Development Association (IDA).

Many of these countries have long complained that the magnitude of the epidemic in their countries, coupled with the lack of adequate health infrastructure, puts anti-retroviral therapy way beyond their health budgets. They have repeatedly appealed for greater international aid.

U.S. AIDS campaigners welcome the moves but say the Bank's plans skirt root issues within its purview. These include poor countries' burden of debt, which leaches resources from areas like health care; requirements of Bank loans that restrict people's access to affordable health services; and intellectual property regimes that put patented medications beyond the reach of states and individuals alike.

"This is a nice down payment," says Benjamin Wikler, co-founder of the U.S. Student Global AIDS Campaign, "but a serious cure will cost much, much more." Campaigners note that U.N. Secretary-General Kofi Annan has said that 8-10 billion dollars per year is needed to get the global AIDS epidemic under control and complain that Annan's Global Fund for HIV, Tuberculosis and Malaria has been woefully under-funded for its initial year.

"Our demands for the World Bank are an end to all conditionalities, such as user fees or mandates for privatisation, as these are counterproductive to public health," says Julie Davids of the non-governmental Health GAP Coalition and ACT UP Philadelphia. She also urges "full cancellation of debt using the Bank's and IMF's (International Monetary Fund's) own resources, through mechanisms such as revaluation of their gold holdings."

Davids argues that the most pressing issues in the global fight against AIDS are the provision of public health services, including access to medicine for people at risk and already infected.

Provision of these services is blocked by the crushing debt burden; lack of significant financial assistance from developed nations, and resistance to bulk procurement and distribution of lowest cost AIDS treatments, she asserts.

"There are three key components to an effective AIDS response," she adds.

"Donate the dollars, drop the debt, and treat the people. Without all three, we do not have a balanced, viable approach and partial efforts are likely to topple."

"It strikes me as sad that sub-Saharan nations spend much more on debt servicing than spending on vital health needs and then must appeal to the World Bank for a fragment of these funds to be returned in order to combat a mounting epidemic," says Davids.

Zewide, however, defends the Bank, saying the institution stands at the forefront of debt reduction efforts for countries with health problems.

"This is what we do everyday," she says. "Any country with a coherent strategy to fight AIDS will be considered for debt reductions. We will continue to work on that in the future."

U.S. groups also accuse their own government, the largest shareholder in the Bank, of lacking the political will to rally international support to save hundreds of thousands of lives lost to AIDS when it quickly mustered enough support to go to war in Afghanistan.

"We need to respond to AIDS on par with terrorism. Millions (have) died of AIDS," says Wikler, "and if (U.S. President George W.) Bush called his friends in London, Germany, India and South Africa, they would have been able to come up with a serious response and save millions of lives and many others in the future."

Wikler, a 20-year-old student at Harvard University, says his government's apathy spurred him to start the U.S. student AIDS group. "One day I realised that my generation was being wiped out but my government, which I expected to do something about it, was only turning out not money but press releases," he explains.

Activists like Wikler and Davids traditionally have been dismissed as well meaning and naive but they have carved out a niche for themselves in the political and public relations marketplace.

Pressure from groups such as theirs is broadly - if sometimes grudgingly - credited with persuading multinational drug makers to drop a lawsuit against South Africa, through which the companies asserted their intellectual property rights in a bid to block the country from importing cheap medicines.

Activists greeted the companies' manoeuvre with what amounted to a shrill and sustained chorus of 'murder': They repeatedly accused the 39 pharmaceutical giants - and, by extension, any politician supporting them - of putting profits over lives, especially those of Africans. (END/IPS/NA/HE/EM/AA/01)
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